Abstract P291: History of Preeclampsia and Subclinical Cardiovascular Disease in Mexican Women

Abstract

Introduction: Preeclampsia is a multisystem hypertensive disorder that affects 4 to 16% of all pregnancies worldwide. Because of its impact on maternal mortality and morbidity, it is considered a major public health problem. However its role as a risk factor for future cardiovascular events, especially subclinical cardiovascular disease, remains unknown. Hypothesis: Women with history of preeclampsia have an increased risk of subclinical cardiovascular disease (sCVD) compared with women with normal pregnancies. Methods: We conducted a cross-sectional analysis of a sample of 1999 women without cardiovascular disease from the Mexican Teacher's Cohort to assess the relationship between history of preeclampsia and carotid intima media thickness (IMT). Information about preeclampsia diagnosis was collected using self-report data from a questionnaire answered by the participants in 2008-2010 which included questions about reproductive history. Carotid IMT was measured on both carotid arteries through ultrasound by standardized neurologists and log transformed. We defined sCVD as mean right and left IMT >0.8mm or the presence of a plaque. Multivariable lineal and logistic regressions were performed to estimate the association between women with history of preeclampsia and IMT or sCVD respectively adjusting for age, sociodemographic factors, BMI at age 18, and age at first pregnancy. Results: Women with a history of preeclampsia (187 of 1999) had slightly higher IMT values (0.69 [IQR 0.12]) than women without (0.67 [IQR 0.12]); they also showed higher prevalence of diabetes (34.7% [65 of 187] vs. 16.8% [306 of 1811]), hypertension (33.1% [62 of 187] vs. 21.9% [398 of 1811]), overweight (44.3[83 of 187] % vs. 41.6% [754 of 1811] ), and obesity (43.3% [81 of 187] vs. 35.1% [636 of 1811). The adjusted IMT was 2.36% (95% CI 0.48, 4.27) higher in women with history of preeclampsia compared with those without. There seems to be an association between preeclampsia and sCVD in the adjusted logistic regression model (odds ratio 1.53 95% CI, 0.97, 2.41), however the association lacked statistical significance. Conclusion: We found an association between history of preeclampsia and increased carotid IMT values. This results support the need of considering the history of preeclampsia in the risk assessment of cardiovascular disease among women later in life to initiate preventive strategies.